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The impact of anti-hypertensive treatment on foetal growth and haemodynamics in pregnant women with pre-existing diabetes - An explorative study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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  3. Differences in insulin sensitivity in the partial remission phase of childhood type 1 diabetes; a longitudinal cohort study

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    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Apolipoprotein D and transthyretin are reduced in female adolescent offspring of women with type 1 diabetes: The EPICOM study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Early Coronary Atherosclerosis in Women With Previous Preeclampsia

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  3. Does group size matter during collaborative skills learning? A randomised study

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Objectives: To explore the impact of anti-hypertensive treatment of pregnancy-induced hypertension on foetal growth and hemodynamics in women with pre-existing diabetes. Methods: A prospective cohort study of 247 consecutive pregnant women with pre-existing diabetes (152 type 1 diabetes; 95 type 2 diabetes), where tight anti-hypertensive treatment was initiated and intensified (mainly with methyldopa) when office blood pressure (BP) ≥135/85 mmHg and home BP ≥130/80 mmHg. Foetal growth was assessed by ultrasound at 27, 33 and 36 weeks and foetal hemodynamics were assessed by ultrasound Doppler before and 1–2 weeks after initiation of anti-hypertensive treatment. Results: In 215 initially normotensive women, anti-hypertensive treatment for pregnancy-induced hypertensive disorders was initiated in 42 (20%), whilst 173 were left untreated. Chronic hypertension was present in 32 (13%). Anti-hypertensive treatment for pregnancy-induced hypertensive disorders was not associated with foetal growth deviation (linear mixed model, p = 0.681). At 27 weeks, mainly before initiation of anti-hypertensive treatment, the prevalence of small foetuses with an estimated foetal weight <10th percentile was 12% in women initiating anti-hypertensive treatment compared with 4% in untreated women (p = 0.054). These numbers were close to the prevalence of birth weight ≤10th percentile (small for gestational age (SGA)) (17% vs. 4%, p = 0.003). Pulsatility index in the umbilical and middle cerebral artery remained stable after the onset of anti-hypertensive treatment in a representative subgroup (n = 12, p = 0.941 and p = 0.799, respectively). Conclusion: There is no clear indication that antihypertensive treatment causes harm in this particular at-high-risk group of pregnant women with diabetes, such that a larger well-designed study to determine the value of tight antihypertensive control would be worthwhile.

OriginalsprogEngelsk
Artikelnummere14722
TidsskriftDiabetic medicine : a journal of the British Diabetic Association
Vol/bind39
Udgave nummer4
ISSN0742-3071
DOI
StatusUdgivet - apr. 2022

Bibliografisk note

© 2021 Diabetes UK.

ID: 73320660